Technology and Social Isolation, Loneliness, and Health Inequities Among Older Adults

Abstract Because of the COVID-19 pandemic, older adults have been advised to stay-at-home to reduce the risk of infection. Social distancing and quarantine measures increase their vulnerability to adverse health outcomes like depression and cardiovascular disease. Technology is an effective tool to promote social connectedness among older adults affected by the pandemic; however, its role in reducing loneliness and health inequities is not well understood. The goal of this project was to construct a model for how technologies may be deployed to mitigate the impact of a pandemic on social isolation, loneliness, and health inequities for older adults. PubMed, SCOPUS, and PsychINFO were searched for the following keywords: “social isolation,” “loneliness,” “social support,” “resilience,” “technology,” “pandemic,” and “health inequities.” Articles selected for full analysis attempted to understand or observe how technology alleviates social isolation and/or loneliness among older adults. Research evidence indicates that using technology reduces loneliness directly and indirectly (by reducing social isolation) and can strengthen social support, which in turn promotes resilience among older adults. Video-based technologies encourage care-seeking behaviors in this population. There is insufficient evidence to determine technology’s relationship to health inequities experienced by older adults. The model we have proposed should help advance research on the relationship between technology and health inequities among older adults that may be aggravated by pandemic-like situations. We hypothesize that technology interventions for social support and functional competence should be sequenced in order to have the best effects on reducing health disparities.


Brandeis University, Brandeis University, Massachusetts, United States
There are mixed findings as to whether social media use (SMU) is positively or negatively related to well-being (positive/negative affect), and this relationship varies by age. The current study seeks to further explore this relationship by examining physical activity (PA) as a potential mediator at both a within (intraindividual) and between-person (interindividual) level across adulthood. The data are from the Midlife in the United States Refresher eight-day daily diary study (N=782, ages 25-75) with self-reported frequency of SMU, PA, and well-being (positive/negative affect).
Multilevel structural equation modeling simultaneously tested how the relationships between the variables differed at both the between-and within-person levels. Between-person results showed that across the week, those who reported less SMU reported engaging in more PA, and more PA was associated with more positive affect. PA significantly mediated the relationship between SMU and positive affect for midlife and older adults, but not for younger adults. Effects for negative affect were not significant. Within-person results indicated that days with more PA were associated with more positive affect; however, PA did not mediate the relationship between SMU and positive or negative affect. These findings suggest the benefits of engaging in PA on one's positive emotional well-being at both the between-and within-person levels. However, for midlife and older adults, more SMU across the week may take away time from engaging in PA, which in turn lowers their positive affect. Implications of the effects of SMU on PA and well-being across adulthood are discussed.

TECHNOLOGY AND SOCIAL ISOLATION, LONELINESS, AND HEALTH INEQUITIES AMONG OLDER ADULTS
Jeffrey Jutai, and Joshua Tuazon, University of Ottawa, Ottawa, Ontario, Canada Because of the COVID-19 pandemic, older adults have been advised to stay-at-home to reduce the risk of infection. Social distancing and quarantine measures increase their vulnerability to adverse health outcomes like depression and cardiovascular disease. Technology is an effective tool to promote social connectedness among older adults affected by the pandemic; however, its role in reducing loneliness and health inequities is not well understood. The goal of this project was to construct a model for how technologies may be deployed to mitigate the impact of a pandemic on social isolation, loneliness, and health inequities for older adults. PubMed, SCOPUS, and PsychINFO were searched for the following keywords: "social isolation," "loneliness," "social support," "resilience," "technology," "pandemic," and "health inequities." Articles selected for full analysis attempted to understand or observe how technology alleviates social isolation and/or loneliness among older adults. Research evidence indicates that using technology reduces loneliness directly and indirectly (by reducing social isolation) and can strengthen social support, which in turn promotes resilience among older adults. Video-based technologies encourage careseeking behaviors in this population. There is insufficient evidence to determine technology's relationship to health inequities experienced by older adults. The model we have proposed should help advance research on the relationship between technology and health inequities among older adults that may be aggravated by pandemic-like situations. We hypothesize that technology interventions for social support and functional competence should be sequenced in order to have the best effects on reducing health disparities.

THE ASSOCIATION BETWEEN SOCIAL SUPPORT AND ATTITUDE TOWARD TECHNOLOGY DIFFERS BY EDUCATIONAL LEVEL
Susanna Joo, 1 Changmin Lee, 2 Kwang Joon Kim, 3 DaeEun Kim, 2 and Hey Jung Jun, 2 , 1. Yonsei University, Republic of Korea,2. Yonsei University,Seoul,Republic of Korea,3. Severance Hospital,Yonsei University College of Medicine,Seoul,Republic of Korea The present study aimed to examine the moderating effects of the educational context on the association between social support from family members and attitude toward using gerontechnology among Korean older adults. The sample was Korean older adults without dementia (N=310, Age: 65-89, M=70.18, SD=4.58). Data were collected by online recruiting in February 2021. The dependent variable was the attitude toward using gerontechnology, especially, an exoskeleton robot for exercise. Independent variables were four types of social support (emotional, instrumental, physical, and financial support) from family members. Moderating variable was the binary educational group (high school and below, or college and over). We analyzed four regression models including each interaction term between education and a type of social support using PROCESS macro and bootstrapping. Results showed educational context had a single significant moderating effect on the association between emotional support and attitude toward using gerontechnology. Specifically, emotional support had a significant effect on having a positive attitude toward using gerontechnology among older adults who graduated high school or were less educated. However, it was not significant among older adults who were highly educated. Moreover, other types of social support did not have significant main effects as well as interaction effects with education on the attitude toward using gerontechnology. Findings of the present study implied emotional support from family members, such as spouse, children, or siblings, was useful to enhance having a positive attitude toward using new technology, especially for older adults who did not experience college-level educational context.

THE ASSOCIATION BETWEEN SPOUSAL SUPPORT AND ATTITUDE FOR GERONTECHNOLOGY VIA FACILITATING CONDITIONS
Seong Hee Kim, 1 Susanna Joo, 2 Changmin Lee, 3 Kwang Joon Kim, 4 DaeEun Kim, 3 YoonMyung Kim, 3 and Hey Jung Jun, 3 , 1. Sungkyunkwan University, Republic of Korea,2. Yonsei University,Republic of Korea,3. Yonsei University,Seoul,Republic of Korea,4. Severance Hospital,Yonsei University College of Medicine,Seoul,Republic of Korea This study examined the mediating effects of facilitating conditions (FC) on the association between types of social support providers and attitude toward using gerontechnology (AUG) or between types of social support and AUG. The sample was 256 older Koreans having a partner and children (N=256; 66-88 years old; M=69.91; SD=4.19). The dependent variable was AUG in terms of an exoskeleton robot for exercise. There were two kinds of independent variables: 1) four types of social support provider (spouse, children, siblings/relatives, and friends/neighbors), and 2) four types of social support (emotional, instrumental, physical, and financial support). Mediating variable was calculated as the mean of FC from five questions. There were two analytic steps: 1) structural equation modeling with four latent variables about types of social support provider, and 2) path analysis with four types of social support if only for significant providers at the first analysis. The results from the first step of analysis showed that only social support from spouses had a significant effect on AUG via FC to use gerontechnology. In the second step of analysis, emotional support from spouses was associated with the higher level of AUG via FC to use gerontechnology. The findings could shed light on the salience of emotional support from spouses in terms of the positive attitude on technology usage in later life through enhancing FC for technology acceptance.

THE ASSOCIATION BETWEEN THE TYPES OF EXERCISE MOTIVATION AND SOCIAL PRESENCE ABOUT GERONTECHNOLOGY
Si Young Song, 1 Inhye Jung, 1 Miseon Kang, 1 Kwang Joon Kim, 2 DaeEun Kim, 1 and Hey Jung Jun, 1 ,1. Yonsei University,Seoul,Republic of Korea,2. Severance Hospital,Yonsei University College of Medicine,Seoul,Republic of Korea The purpose of this study was to identify the types of exercise motivation and examine the association between the types of exercise motivation and social presence about exercise-related gerontechnology among Korean young-olds. In this study, social presence about gerontechnology implies the degree of perception of a robot that helps exercise functions as human-like socially interacting entities (Heerink, 2010). Online survey data collected from the Korean older adults over the age of 65 in February 2021 was used, and the subjects of this study were 154 young-olds aged 65 to 74 who exercise regularly. Latent class analysis (LCA) was conducted to classify the types of exercise motivation, followed by multiple regression analysis. As a result of LCA, the types of exercise motivation was classified with two groups. These groups were named 'for pleasure and leisure (PL, 77.2%)' and 'for maintenance of health (MH, 22.8%)', respectively. The result of multiple regression showed that compared to the second group (MH), the social presence about gerontechnology was high for the first group (PL) after controlling age, gender, education level, marital status, household income and chronic disease. These results indicate the Korean young-olds' exercise motivation may vary and expectations for social presence toward exercise-related gerontechnology differ depending on the exercise motivation. To date, the importance of social presence in gerontechnology has tended to be emphasized mainly in the care field. This study suggests that exercise-related gerontechnology devices also need to consider the aspect of social presence especially for youngolds who exercise for pleasure and leisure.